1976, 10-12 Permit App: L5855 Revision L5456� � s
CjntY of Spokane. WashIgton
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BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT GENERAL REQUIREMENTS PERMIT FEE ........ ....... ........
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structuref a"
kind or alter any building or structure already erected, or to change a land use. Construction must conform w b the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
performed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer.
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
Highway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner d U v' �' Address ' r!- � t' SS ` CI Phone ��� - V7 G�
Architect Address Phone
Engineer Address Phone
Contractor Address Phone S`
Leal Description of Property (Give complete descriptio�rom �1d,/tax reFeipt, e
� tc.)
��f �L �,�
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone —�— Fire Zone 3
Size of Lot Sewage Systemonst.
Pr., Conc., Br., etc.)
Stories Dimensions Total Sq. Ft.7vT Valuation--
Rooms Baths Basement Foundation Const. Chimney Kind) Fireplac (Number
Fu 11, part, none)
Heat. System Type of Roofing Ext. Finish Int. Wall Finish
Use of BidNo. of Units —Bedrooms
S."�, <, .,
PLOT PLAN .
Draw ske ch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH RESIDENTIAL — COMMERCIAL State License No.
Ind. Ins. Acct. No.
��� C=C -✓L C�r�L�� _c c��
REQUIRED
Plumbing Permit
rn Heating Permit
a
N N Sewage Permit
-4
ail/ � . ,,� � Plans Received
Plans Checked
Plans Returned
U ►� \ Plans Picked Up
Plans Mailed
SOUTH
'i
1 her certify nfo / ion submitted is correct and there are no other structures located on this property except
as show G iJ✓t-� i
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRQ* BELOW THIS LINE
ur street address will be r 'X/i The zone is
Sewage Permit Number Issued Building Per it— Receipt Issued ;
Remarks I
Form A23 Rld— Cede